Chan Shannon Melissa, Chan Daniel, Yip Hon Chi, Scheppach Markus Wolfgang, Lam Ray, Ng Stephen Kk, Ng Enders Kwok Wai, Chiu Philip W
Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
Surgery, UNSW St George & Sutherland, Kogarah, Australia.
Endosc Int Open. 2025 Apr 15;13:a25476645. doi: 10.1055/a-2547-6645. eCollection 2025.
BACKGROUND AND STUDY AIMS: Completeness of esophagagogastroduodenoscopy (EGD) varies among endoscopists, leading to a high miss rate for gastric neoplasms. This study aimed to determine the effect of the Cerebro real-time artificial intelligence (AI) system on completeness of EGD for endoscopists in early stages of training. PATIENTS AND METHODS: The AI system was built with CNN and Motion Adaptive Temporal Feature Aggregation (MA-TFA). A prospective sequential cohort study was conducted. Endoscopists were taught about the standardized EGD protocol to examine 27 sites. Then, each subject performed diagnostic EGDs per protocol (control arm). After completion of the required sample size, subjects performed diagnostic EGDs with assistance of the AI (study arm). The primary outcome was the rate of completeness of EGD. Secondary outcomes included overall inspection time, individual site inspection time, completeness of photodocumentation, and rate of positive pathologies. RESULTS: A total of 466 EGDs were performed with 233 in each group. Use of AI significantly improved completeness of EGD [mean (SD) (92.6% (6.2%) vs 71.2% (16.8%)]; <0.001 (95% confidence interval 19.2%-23.8%, SD 0.012). There was no difference in overall mean (SD) inspection time [765.5 (338.4) seconds vs 740.4 (266.2); =0.374]. Mean (SD) number of photos for photo-documentation significantly increased in the AI group [26.9 (0.4) vs 10.3 (4.4); <0.001]. There was no difference in detection rates for pathologies in the two groups [8/233 (3.43%) vs 5/233 (2.16%), =0.399]. CONCLUSIONS: Completeness of EGD examination and photodocumentation by endoscopists in early stages of are improved by the AI-assisted software Cerebro.
背景与研究目的:食管胃十二指肠镜检查(EGD)的完整性在不同内镜医师之间存在差异,导致胃肿瘤的漏诊率较高。本研究旨在确定Cerebro实时人工智能(AI)系统对处于培训早期阶段的内镜医师进行EGD检查完整性的影响。 患者与方法:AI系统采用卷积神经网络(CNN)和运动自适应时间特征聚合(MA-TFA)构建。进行了一项前瞻性序贯队列研究。向内镜医师传授标准化的EGD检查方案以检查27个部位。然后,每个受试者按照方案进行诊断性EGD检查(对照组)。在达到所需样本量后,受试者在AI辅助下进行诊断性EGD检查(研究组)。主要结局是EGD检查的完整性率。次要结局包括总检查时间、各个部位的检查时间、摄影记录的完整性以及阳性病理结果率。 结果:共进行了466次EGD检查,每组233次。使用AI显著提高了EGD检查的完整性[均值(标准差)(92.6%(6.2%)对71.2%(16.8%)];P<0.001(95%置信区间19.2%-23.8%,标准差0.012)。总平均(标准差)检查时间无差异[765.5(338.4)秒对740.4(266.2);P=0.374]。AI组摄影记录的平均(标准差)照片数量显著增加[26.9(0.4)对10.3(4.4)];P<0.001。两组病理结果的检出率无差异[8/233(3.43%)对5/233(2.16%),P=0.399]。 结论:AI辅助软件Cerebro提高了处于早期阶段的内镜医师进行EGD检查及摄影记录的完整性。
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